Blood pressure levels and mortality risk among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study

摘要: KDOQI practice guidelines recommend predialysis blood pressure <140/90 mm Hg; however, most prior studies had found elevated mortality with low, not high, systolic pressure. This is possibly due to unmeasured confounders affecting and mortality. To lessen this bias, we analyzed 24,525 patients by Cox regression models adjusted for patient facility characteristics. Compared of 130-159 mm Hg, was 13% higher in facilities 20% more at 110-129 mm Hg 16% ≥160 mm Hg. For patient-level pressure, low (<130 mm Hg), high (≥180 mm Hg), diastolic lowest 60-99 mm Hg, a wide range implying less chance improve outcomes. Higher <130 mm Hg consistent may be excessive lowering during dialysis. The risk 130-159 mm Hg indicates optimal, but have been influenced practices. While additional study needed, our findings contrast targets, provide guidance on optimal the absence definitive clinical trial data.